Call Vector Medical Billing
+1 (929) 539-7737
50States
Hepatology Billing Services
Hepatology billing keeps the visit and a procedure or infusion on separate lines when both happen — then FibroScan frequency, biopsy guidance, paracentesis, and antiviral auth. Vector Medical Billing, in Jamaica, New York, scrubs liver staging diagnoses and drug pathways inside the EHR you already use.
98%Published NCR
24hClaim Submission
BAASigned with every client
AAPCCertified coders
AHIMACertified coders
E&OErrors and omissions insured
50 StatesRemote billing nationwide
Monthly fee
What hepatology billing services include
Full-cycle RCM for liver clinics — chronic hepatitis and cirrhosis visits, staging procedures, and specialty-drug coordination on one account.
The operating cycle matches medical billing services: eligibility and prior auth, charge capture from visit notes and procedure records, ICD-10 / CPT / HCPCS coding, scrub, clearinghouse submission, payment posting, denial management, and A/R follow-up. The scrub watches visit-vs-procedure separation, elastography frequency limits, biopsy and guidance bundling, paracentesis with vs without imaging, medical vs pharmacy benefit routing for antivirals, and cirrhosis staging diagnoses that support MDM and coverage.
In scope: office/outpatient E/M (± G2211 when Medicare longitudinal criteria fit), transient elastography / FibroScan, ultrasound elastography when imaged and reported, percutaneous liver biopsy, diagnostic and therapeutic paracentesis, albumin or other supportive infusions when buy-and-bill in office, hepatitis B and C treatment management visits with DAA/antiviral auth tracking, HCC surveillance imaging orders with medical-necessity diagnoses, and CCM or principal care management when the practice meets time and consent rules. Dedicated gastroenterology billing covers endoscopy and variceal banding suites when that is a separate GI account — hepatology procedure and visit work stays here. Transplant listing and inpatient transplant episodes belonging to a transplant center stay outside this percentage unless scoped separately.
The fee is a percentage of net collections. The written rate is on pricing. Credentialing, a retrospective coding audit, MIPS, and out-of-network / IDR stay separate engagements.
What sits on this hepatology fee
- Visit, procedure, and infusion kept on separate lines when all are real
- Elastography frequency and antiviral auth watched before denials age
- HIPAA workflows, a signed BAA, and PHI limited to staff on the account
Where hepatology claims fail
Patterns specialty liver RCM vendors keep naming on staging and antiviral days.
Visit collapsed into the procedure
Same-day FibroScan, biopsy, or paracentesis billed without a separately identifiable E/M — or habit-25 on a note that only documents the procedure. Infusion days lose the drug or admin while only the visit posts.
Hub rule: visit and procedure or infusion stay on separate lines when both happen.
Elastography frequency denials
FibroScan booked over the plan’s annual cap, or within a restricted window after liver biopsy. Wrong code family (91200 vs imaged elastography) or missing chronic liver diagnosis on the claim.
Frequency and indication are scrubbed before the slot is confirmed.
DAA / antiviral auth gaps
Hepatitis C direct-acting antivirals started without current prior auth, genotype or fibrosis staging missing from the packet, or pharmacy-benefit drugs forced onto the medical claim. HBV long-term therapy reauthorization missed.
Auth is a case before the first fill — not after the denial lands.
Visit · procedure · not one line
Visit and procedure or infusion — separate lines
Hub language made operational: two (or three) claim stories when all are real.
Office E/M for cirrhosis, NAFLD/NASH, viral hepatitis, autoimmune hepatitis, and post-transplant clinic follow-up bills by MDM or time. Medicare G2211 may append when the hepatologist is the continuing focal point for a serious or complex condition — not on every quick return, and generally not stacked with 25 on the same visit except narrow exceptions.
When FibroScan, biopsy, paracentesis, or an infusion shares the day, the procedure or administration is its own line. Modifier 25 on the E/M only when a significant, separately identifiable evaluation is documented beyond the procedure or chair time. Buy-and-bill albumin or other office infusions follow therapeutic administration hierarchy plus J-code units and JW/JZ — not collapsed into the visit.
Same-day checklist
- E/M note shows work beyond the procedure or infusion
- Procedure and drug/admin lines present when performed
- Liver disease staging ICD-10 supports medical necessity
FibroScan and liver elastography
Code family, frequency limits, and diagnosis drive payment.
91200 vs imaged elastography
Transient elastography without a separately reported imaging interpretation commonly maps to 91200. When ultrasound elastography includes image guidance, interpretation, and a saved report, use the appropriate ultrasound elastography code (e.g. 76981 family) — not both for the same measurement without payer support. Abdominal ultrasound for HCC surveillance (76700 / 76705) is a different service; check NCCI when both run the same day.
Frequency and biopsy windows
Many commercial plans cap elastography at roughly twice per year and deny it within a set window after liver biopsy. Track last biopsy and last FibroScan dates in the chart before scheduling. Chronic hepatitis, NAFLD with fibrosis risk, and cirrhosis diagnoses belong on the claim — symptom-only codes often fail lab and imaging policies.
Biopsy, paracentesis, and office procedures
Guidance bundling and who owns imaging.
Percutaneous liver biopsy
47000 for needle biopsy. Imaging guidance (e.g. 76942) may be separately reportable when documented and not bundled by the payer. Indication, pass count, and specimen handling belong in the note. Pathology of the core is usually billed by the performing lab or pathologist — not invented on the hepatologist claim.
Paracentesis
49082 without imaging guidance; 49083 with imaging guidance already included — do not add 76942 to 49083. Therapeutic large-volume taps may pair with albumin infusion when buy-and-bill; admin and drug stay apart from the procedure and the visit.
Facility vs office
Hospital outpatient or ASC place of service changes packaging and who bills the technical component. Office (POS 11) claims must not duplicate facility lines. Endoscopic variceal therapy usually sits on the GI endoscopy account — link here only when the hepatologist owns that professional claim.
Hepatology code families this service works
Illustrative anchors — the note, imaging record, auth, and payer policy decide the final claim.
| Work type | Example | What to check | Common failure if skipped |
|---|---|---|---|
| Office E/M | 99202–99215 ± G2211 ± 25 | Separate from procedure/infusion | Habit-25 on procedure-only day |
| Elastography | 91200 / 76981 family | Imaged vs non-imaged; frequency | Cap or post-biopsy denial |
| Abdominal US | 76700 / 76705 | HCC surveillance Dx; NCCI | Bundled with elastography |
| Liver biopsy | 47000 ± guidance | Indication; guidance rules | 76942 unbundled wrongly |
| Paracentesis | 49082 / 49083 | With vs without guidance | Extra 76942 on 49083 |
| Supportive infusion | 96365 + J-albumin | Units; JW/JZ; separate from visit | Drug omitted |
| Viral hepatitis Dx | B18.x / B19.x / K74.x | Chronic vs acute; cirrhosis stage | Unspecified liver disease only |
| DAA / HBV Rx | Pharmacy benefit | Auth packet complete | Forced onto medical claim |
| Care management | 99490 / 99424 families | Consent; monthly time | Billed without tracked minutes |
This page does not invent a hepatology denial percentage. The free audit reads your visit/procedure split, elastography dates, and auth gaps on the sample you send.
What a free audit line looks like
Illustrative composite only — not a client result and not a promised recovery.
| Field | Example entry |
|---|---|
| Documented service | Compensated cirrhosis follow-up with medication adjustment; same-day FibroScan (last FibroScan 14 months prior; no biopsy in 12 months); separately identifiable E/M documented |
| Billed codes | 99214-25 only; elastography never charged |
| Issue found | Procedure line omitted; visit alone understates the day |
| Recommended correction | 99214-25 (if E/M stands) + 91200 (or imaged elastography code if documentation supports) with cirrhosis/chronic liver Dx |
| Related check | Payer frequency limit not exceeded; not within restricted post-biopsy window |
| Why it matters | Staging procedure revenue left on the table — caught in scrub or flagged in the free audit |
Request a Free Audit with recent notes, claims, and denials. We map visit, procedure, and infusion lines on your file — not this composite.
How Vector runs hepatology billing
Auth and frequency first — then the same revenue cycle.
1
Assign hepatology
Coder and biller who already work elastography frequency, biopsy/paracentesis bundling, and antiviral auth.
2
Reconcile and code
Charge entry and coding from visit and procedure records — queries when staging or guidance cannot be supported.
4
Post and report
835 posting, denial work, A/R aging, monthly RCM report by visit vs procedure vs infusion.
Not inside the hepatology percentage
Related work stays separate so the quote matches the job.
Pharmacy-benefit antivirals
Oral DAAs and most oral HBV agents ride specialty pharmacy — not buy-and-bill on the medical claim. We coordinate auth and benefits investigation; we do not force those fills onto Part B.
Credentialing / audit
Credentialing and a retrospective coding audit of elastography and procedure coding are separate engagements when scoped.
Underpay / OON
Underpayment recovery and OON / IDR stay separate when the dispute path is not ordinary denial work.
How hepatology billing is priced
Percentage of dollars that land — not a flat fee per FibroScan that ignores auth and frequency leaks.
Written rate
The fee is a percentage of net collections. No setup fee on the monthly cycle. Month to month. The written rate follows visit, procedure, and infusion volume and how much of the cycle you hand over.
See pricing or request a written rate after the free audit.
What we need to start
EHR access, monthly visit and procedure census, FibroScan and antiviral volume, open A/R if you are leaving another biller, and a sample of recent elastography or auth denials. Switching usually overlaps so claim submission does not stop. See EHR integration if access setup needs a separate quote.
Audit the liver claims that bill the visit and lose the procedure
Send monthly visit and procedure volume, FibroScan and antiviral mix, EHR name, and a sample of frequency or auth denials. We reply with what the open A/R shows, whether the monthly fee fits, and a written rate — without inventing a clean-claim percentage.
Written
Monthly rate
98%
Published NCR
50
US States
BAA
Every Client
Hepatology billing questions
Straight answers tied to the sections above.
What does hepatology billing include?
Clinic E/M, FibroScan/elastography, liver biopsy, paracentesis, supportive infusions when buy-and-bill, hepatitis antiviral auth coordination, scrubbing, submission, posting, denials, and A/R.
How much do hepatology billing services cost?
The fee is a percentage of net collections. No setup fee on the monthly cycle. The written rate follows visit, procedure, and infusion volume and payer mix.
Are the visit and a procedure or infusion billed separately?
Yes. When both happen, they stay on separate lines. Modifier 25 only when a significant, separately identifiable evaluation is documented beyond the procedure or infusion.
How is FibroScan billed?
Non-imaged transient elastography commonly uses 91200. Imaged ultrasound elastography uses the appropriate imaging code when documentation supports it. Watch payer frequency caps and post-biopsy windows.
Are hepatitis C DAAs billed on the medical claim?
Usually no — they ride the pharmacy benefit with prior auth. The hepatology visit documents staging and monitoring. Office buy-and-bill infusions stay on the medical claim.
Do we have to change our EHR?
No. Billers work in the system you already use — see EHR integration. Compatibility is confirmed before you commit.
Where does Vector provide hepatology billing?
The office is 15717 85th St, Jamaica, NY 11414-2620. Work is remote for hepatology practices in all 50 states. See the specialties hub.
Is Vector Medical Billing HIPAA certified?
HHS does not certify billing companies. Vector signs a BAA, limits PHI to staff on the account, and follows HIPAA workflows. A HIPAA security risk analysis is a separate engagement when scoped.